System and method for determining a subject&#39;s muscle fuel level, muscle fuel rating, and muscle energy status

ABSTRACT

Provided is a non-invasive system and method for determining a fuel value for a target muscle and potentially at least one indicator muscle. The method includes receiving an ultrasound scan of a target muscle; evaluating at least a portion of the ultrasound scan to determine fuel value within the target muscle; recording the determined fuel value for the muscle as an element of a data set for the muscle; evaluating the fuel data set to determine a value range; and in response to the range being at least above a pre-determined threshold, establishing a target score for the muscle as based on an upper portion of the value range. The method may be repeated to identify ranges for a plurality of muscles, the muscle with the greatest range being identified as an indicator muscle. Based thereon, the muscles estimated fuel level, fuel rating and energy status may be determined.

CROSS-REFERENCE TO RELATED APPLICATION

This application is a continuation of U.S. patent application Ser. No.17/410,378, filed Aug. 24, 2021, and entitled “System and Method forDetermining a Subject's Muscle Fuel Level, Muscle Fuel Rating, andMuscle Energy Status” which is a continuation of U.S. patent applicationSer. No. 15/909,593, filed Mar. 1, 2018, and entitled “System and Methodfor Determining a Subject's Muscle Fuel Level, Muscle Fuel Rating, andMuscle Energy Status,” now U.S. Pat. No. 11,160,493, which claims thebenefit under 35 U.S.C. § 119(e) of U.S. Provisional Patent ApplicationNo. 62/466,844, filed Mar. 3, 2017, and entitled “System and Method forMuscle Energy Status Determination and Evaluation,” the contents ofwhich are incorporated by reference as if fully disclosed herein.

FIELD

The present invention relates generally to the determination of musclefuel in animal and human tissue, and more specifically to thenon-invasive determination of a muscle fuel level, muscle fuel rating,and overall muscle energy status in animal and human tissue.

BACKGROUND

Skeletal muscle makes up approximately 40% of ones total body mass. Thehealth of your skeletal muscles makes an essential contribution to yourwellbeing at any age and at any level of fitness or mobility. Oneindicator of a skeletal muscle's health is how much energy that muscleis storing at any given time.

Muscle's depend on energy for performance. A primary constituent for amuscle's energy is glycogen, as well as other energy constituents, e.g.,protein, carnitine, and creatine. Glycogen is the storage form ofglucose in animal and human tissues. Moreover it is the polysaccharidemolecule that functions as the secondary long-term energy store inanimal cell tissue and may be represented as (C₆H₁₀O₅)_(n). Glycogen ismade up of glucose building blocks, glucose (C₆H₁₂O₆) being amonosaccharide, or simple sugar and an important carbohydrate inbiology. Glycogen is made primarily by the liver and the muscles, but itcan also be made by glycogenesis within the brain and stomach. Proteins,carnitine and creatine are each constituents involved in supportinghealthy muscle performance, being involved in muscle metabolism, ATPproduction, and/or other energy involved processes. However, glycogenand other energy constituents have traditionally only been measured by alimited number of intrusive procedures, like biopsies, or estimatesbased on past performance parameters. These techniques have limitedutility, and provide little guidance on a real time scale.

Hence there is a need for a method and system that is capable ofproviding non-intrusive determinations for how much energy a muscle isstoring, particularly methods and systems that can be performed at realtime.

SUMMARY

This invention provides methods and systems for the non-invasivedetermination of fuel, fuel level, fuel rating and energy status for amuscle and, therefore, for the overall performance readiness of amuscle.

In particular, and by way of example only, according to one embodimentof the present invention, provided is a non-invasive method ofdetermining at least one indicator muscle for determination of musclefuel, comprising: receiving from a subject a plurality of ultrasoundscans from a plurality of different muscles over a plurality ofultrasound scanning sessions; for each received ultrasound scan of eachmuscle, evaluating at least a portion of the ultrasound scan todetermine a fuel value within the muscle, the collective fuel valuesbeing a data set for the muscle; evaluating each fuel data set todetermine a range for each muscle; ranking the scanned muscles bydetermined range; and selecting at least the highest ranked muscle as atleast one indicator muscle.

In one embodiment, provided is a non-invasive method of determining atarget fuel level for a target or indicator muscle, comprising:receiving from a subject a plurality of ultrasound scans of the targetmuscle over a plurality of ultrasound scanning sessions; for eachreceived ultrasound scan, evaluating at least a portion of theultrasound scan to determine fuel values within the muscle, thecollective fuel values being a fuel value data set for the muscle;evaluating the data set to determine a value range and assigning amaximum fuel value as 100 and a minimum fuel value as 1; evaluating anew real time ultrasound scan and determining the fuel value, such thatthe new fuel value is placed within the 100 to 1 fuel value range; andassigning a fuel level for the muscle. In aspects of the aboveembodiment, the fuel level is provided as a percentage and likened to afuel tank.

In another embodiment, the target or indicator muscle's fuel level iscompared to a fuel level data set for the same muscle in otherindividuals. The comparison provides a fuel rating (or how does thetarget muscle compare to others who have been tested in the same way)for the target muscle. In some aspects, the other individuals are thesame gender as the subject, are the same age as the subject, or competein the same athletic endeavors as the subject.

In still another embodiment, the target or indicator muscle's fuel leveland fuel rating are combined to provide a composite score. The compositescore is indicative of a muscle energy status for the target muscle, ora muscle readiness for the target muscle. As for muscle ratings, muscleenergy status can be compared to other individuals, and can be definedas a numeric score (1-100) or a status score (low, average, high).

In some aspects, the fuel level, fuel rating or energy status for atarget muscle can be compared against the same score established for itscontralateral muscle to provide a muscle fuel symmetry. Target musclesthat are non-symmetric with regard to muscle fuel level, muscle ratingor energy status are at a higher risk of injury.

BRIEF DESCRIPTION OF THE DRAWINGS

At least one method and system for non-invasive determination ofglycogen stores will be described, by way of example in the detaileddescription below with particular reference to the accompanying drawingsin which like numerals refer to like elements, and:

FIG. 1 illustrates a high level block diagram of a system fornon-invasive determination of fuel in accordance with at least oneembodiment;

FIG. 2 is a conceptual illustration of an ultrasound scan of a targetmuscle in accordance with at least one embodiment;

FIG. 3 illustrates a high level flow diagram for a method ofnon-invasive determination of fuel in accordance with at least oneembodiment;

FIG. 4 is a refined flow diagram of the evaluating operation fornon-invasive determination of fuel in accordance with at least oneembodiment;

FIG. 5 is a conceptual illustration of an ultrasound scan of a targetmuscle at a first time interval in accordance with at least oneembodiment;

FIG. 6 is a conceptual illustration of the ultrasound scan of FIG. 5with a grid and area attribute valuations in accordance with at leastone embodiment;

FIG. 7 is a conceptual illustration of an ultrasound scan of a targetmuscle at a second time interval with a grid and area attributevaluations in accordance with at least one embodiment;

FIG. 8 is a conceptual illustration of an ultrasound scan of a targetmuscle at a third interval a grid and area attribute valuations inaccordance with at least one embodiment;

FIG. 9 is a conceptual illustration of an ultrasound scan of a targetmuscle at a fourth interval a grid and area attribute valuations inaccordance with at least one embodiment;

FIG. 10 is a conceptual illustration of an ultrasound scan of a targetmuscle further showing an automated selection of an area for evaluationin accordance with at least one embodiment;

FIG. 11 is a conceptual illustration of an ultrasound scan of a targetmuscle further showing a user adjusted/determined selection of an areafor evaluation in accordance with at least one embodiment;

FIG. 12 is a chart of the determined fuel values as determined in FIGS.6, 7, 8 and 9 in accordance with at least one embodiment;

FIG. 13 is a conceptual illustration of an ultrasound scan of a targetmuscle further illustrating a first part having a first threshold valueand a second part having a second threshold value in accordance with atleast one embodiment;

FIG. 14 presents multiple charts illustrating the fatigue and thecomparison of different target muscles in accordance with at least oneembodiment;

FIG. 15 is a block diagram of a computer system in accordance with atleast one embodiment; and

FIGS. 16-18 are conceptual illustrations of alternative configurationsfor a system for non-invasive determination of fuel values in accordancewith at least one embodiment;

FIG. 19 illustrates flow charts for determining both muscle targetscores and indicator muscles in accordance with at least one embodiment;

FIG. 20 conceptually illustrates box plots for two muscles so as tofurther illustrate the determination of target muscle scores asdiscussed with respect to FIG. 19 in accordance with at least oneembodiment;

FIG. 21 conceptually illustrates box plots for a plurality of muscles soas to further illustrate the determination of indicator muscles asdiscussed with respect to FIG. 19 in accordance with at least oneembodiment;

FIG. 22 illustrates a estimated fuel level score in accordance with atleast one embodiment;

FIG. 23 illustrates a fuel rating scale and score in accordance with atleast one embodiment;

FIG. 24 illustrates a flow chart for determining muscle energy status inaccordance with at least one embodiment;

FIG. 25 illustrates a series of muscle energy status scores for asubject over the course of several months in accordance with at leastone embodiment;

FIG. 26 illustrates an alternative flow chart for determining muscleenergy status in accordance with at least one embodiment;

FIG. 27 illustrates a fuel symmetry score in accordance with at leastone embodiment;

FIG. 28A-D illustrate one possible muscle energy readout for a subjectin accordance with at least one embodiment;

FIG. 29 depicts a conceptual illustration of a fourth alternativeconfiguration for a system for non-invasive tissue evaluation that maybe used to determine human pennation angle and/or fascicle length inaccordance with at least one embodiment;

FIG. 30 depicts a conceptual illustration of a fifth alternativeconfiguration for a system for non-invasive determination of humanpennation angle and/or fascicle length in accordance with at least oneembodiment; and

FIG. 31 depicts a conceptual illustration of a sixth alternativeconfiguration for a system for non-invasive determination of humanpennation angle and/or fascicle length in accordance with at least oneembodiment.

DETAILED DESCRIPTION

Before proceeding with the detailed description, it is to be appreciatedthat the present teaching is by way of example only, not by limitation.The concepts herein are not limited to use or application with aspecific system or method for non-invasive determination of a muscle'sfuel. Thus although the instrumentalities described herein are for theconvenience of explanation shown and described with respect to exemplaryembodiments, it will be understood and appreciated that the principlesherein may be applied equally in other types of systems and methodsinvolving in the non-invasive determination of fuel, fuel levels, fuelrating, fuel symmetry and energy for a muscle.

Glycogen is a polysaccharide made up of glucose—a monosaccharide, orsimple sugar and an important carbohydrate in biology. Indeed glycogenis a principle form of energy storage for an animal and thereforereferred to as a “glycogen store.” Carnitine is a compound found in themuscle involved in the transfer of fatty acids across mitochondrialmembranes. Creatine is a protein involved in energy supply in the muscleand involved in muscle contraction. Other water soluble proteins andenergy constituents are also found in muscle that are useful in buildingand repairing muscle. The combination of glycogen, carnitine, creatineand other proteins is referred to as fuel or muscle fuel herein. Forease of discussion and illustration, the embodiments of systems andmethods as set forth herein discuss and describe non-invasivedetermination of fuel, where fuel may include any useful monosaccharide,polysaccharide, protein, compound and the like useful in providingenergy to a muscle. Each of these fuel constituents improves enduranceof a muscle and delays fatigue, and depletion of a muscle's fuel isindicative of whether a muscle is ready for exercise and possible proneto injury. Each of these constituents is water-bound and enters themuscle tightly associated with water.

Turning to FIG. 1 , presented is a high level block diagram of a systemfor non-invasive determination of muscle fuel (SNDGS) 100. Specifically,SNDS 100 is a fuel evaluator 102 structured and arranged to evaluate atleast one selected portion of a scan 104 of a selected target muscle 106to determine fuel within the target muscle 106.

As used herein the term “scan” is understood and appreciated for itsnormal meaning and as is expected in the medical profession—namely, “a.examination of the body or an organ or part, or a biologically activematerial, by means of a scanning technique such as ultrasonography—anultrasound-based diagnostic imaging technique used for visualizingsubcutaneous body structures b. the image so obtained. Moreover the scanmay be the collection of data from a scanner as well as an imagerepresenting that data, but it need not be an image in all cases.

Further the term “evaluate” and its various derivatives is understoodand appreciated for its normal meaning, namely, “a. to determine or setthe value or amount of; appraise—b. to judge or determine thesignificance, worth or quality of; assess—c. to ascertain the numericalvalue of” However, with respect to the interpretation of scans, it isnot uncommon to refer to the process of interpretation as analyzing, asin, “a. to separate into constituent parts or elements; determine theelements or essential features of—b. to examine critically, so as tobring out the essential elements or give the essence of—c. to examinecarefully and in detail so as to identify causes, key factors, possibleresults, etc. . . . —d. to subject to mathematical, chemical,grammatical, etc., analysis.” Moreover, as used herein, “evaluate” andit's derivative forms are understood and appreciated to encompass theaspects of “analysis” as may be appropriate for a given situation.

In at least one embodiment, SNDGS 100 has a processor-enabled devicesuch as computer 108. Computer 108 is adapted to receive the scan 104 ofa target muscle 106 of a subject 110, FIG. 1 showing only a portion ofthe subject's right leg.

With respect to FIG. 1 , the conceptual illustration suggests thesubject 110 is a human being. Indeed, embodiments of SNDGS 100 areindeed directed towards the non-invasive detection and analysis of fuelwithin human beings, such as for example, elite athletes such asprofessional cyclists, triathletes, speed skaters, swimmers, downhilland slalom skiers, football players, lacrosse players, soccer players,and or other such endurance athletes or individuals such as militarypersonnel, where sustained performance over an extended period of timeis a significant factor in the person's training and conditioning. Itshould also be understood that varying embodiments of SNDGS 100 mightalso be applied to non-human subjects, such as racehorses or otheranimals.

With respect to FIG. 1 , SNDGS 100 is at least in part conceptuallyillustrated in the context of an embodiment for a computer program 112.Such a computer program 112 can be provided upon a non-transitorycomputer readable media, such as an optical disc 114 or RAM drive thatcan be provided to a computer 108 to be adapted as SNDGS 100. As isfurther shown and described in connection with FIG. 16 , in alternativeembodiments the computer program 112 can be provided to a computerserving at least as part of an application providing platform, such asbut not limited to the Apple App Store, that computer in turn operableto provide the computer program to a computer 108 to be adapted as SNDGS100.

As will be discussed further below, SNDGS 100 may be employed upon acomputer 108 having typical components such as a processor, memory,storage devices and input and output devices. During operation, theSNDGS 100 may be maintained in active memory for enhanced speed andefficiency. In addition, SNDGS 100 may also be operated within acomputer network and may utilize distributed resources.

In at least one embodiment, the SNDGS 100 system is provided as adedicated system to provide non-invasive determination of muscle fuel.In at least one alternative embodiment, the SNDGS 100 system is achievedby adapting an existing computer 108 such as a smart phone (such as aniPhone.RTM. or Android.RTM.) or tablet computer (such as an iPad.RTM.)which is portable.

With respect to FIG. 1 , SNDGS 100 has been conceptually illustrated asa tablet computer 108, having a display 116 operable to display a visualrepresentation of the scan 104. The display 116 also is shown to providean indicator 118 to inform an operator of the determined fuel level.

For at least one embodiment, the software may be described as includingan input/receiving routine 120, a define portion routine 122, and anevaluating routine 124. As is set forth and described below, theelements of SNDGS 100 may be summarized or at least one embodiment asfollows.

The input/receiving routine 120 is operable to receive the scan 104,such as a Digital Imaging and Communications in Medicine (DICOM) datafile, and may also receive other information such as the subjects name,location, current state of exertion, etc. . . . The define portionroutine 122 is operable to define a plurality of areas within the scan104 of the target muscle 106. The evaluating routine 124 is operable toevaluate at least one attribute for each of the plurality of areas todetermine the fuel within the target muscle.

In addition to the three core routines, input/receiving routine 120,define area routine 122 and the evaluating routine 124 shown with heavyboarders, in at least one alternative embodiment, SNDGS 100 furtherincludes an ultrasound device having a movable transducer 126 operablein a high frequency range and has a an adjustable depth of scan. Morespecifically, the high frequency range is between about 5 to 20megahertz. In addition the depth of scan is between about 1 centimeterand about 7 centimeters. For at least one embodiment, the ultrasoundtransducer 126 is an existing commercially available and FDA approvedultrasound transducer 126 incorporated as part of SNDGS 100 withoutdeparting from the scope of FDA approval for the operation of theultrasound transducer device.

For at least one embodiment of SNDGS 100, the computer program 112 mayadditionally include a depth of scan routine 128, an imaging routine130, and optionally an output routine 132. Moreover, the depth of scanselector routine 128 is operable to adjust the ultrasound device, e.g.,ultrasound transducer 126, for a depth of scan appropriate for thetarget muscle 106. In at least one embodiment, the proper depth of scanis set based on the selection of a target 106 muscle as indicated by anoperator of SNDGS 100.

The imaging routine 130 is operable to direct the movable transducer 126to scan the selected target muscle 106 by processing ultrasoundreflection received by the transducer to provide at least a partialultrasound scan of the selected target muscle. In at least oneembodiment, the imaging routine 130 is structured and arranged tooperate with a third party ultrasound imaging software provided to thecomputer 108.

For at least one embodiment, the optional output routine 132 is operableto output the scan of the target muscle 106 to a storage device, ordatabase. This output routine may also be configured to provide anaudible, visual or tactile output to inform the operator of SNGDS 100 ofthe determined fuel level for the target muscle 106.

With respect to FIG. 1 , it is understood and appreciated that theelements, e.g., input routine 120, define area routine 122, evaluatingroutine 124, depth of scan routine 128, imaging routine 130, outputroutine 132, ultrasound transducer 126 and computer 108 are in at leastone embodiment located within a single device. In at least onealternative embodiment, these elements may be distributed over aplurality of interconnected devices. Further, although each of theseelements has been shown conceptually as an element, it is understood andappreciated that in varying embodiments, each element may be furthersubdivided and/or integrated with one or more other elements.

FIGS. 2 and 3 in connection with FIGS. 1 and 3-13 provide a high levelflow diagram with conceptual illustrations depicting a method 300 fornon-invasive determination of fuel in accordance with at least oneembodiment. It will be appreciated that the described method need not beperformed in the order in which it is herein described, but that thisdescription is merely exemplary of one method of non-invasivedetermination of muscle fuel.

As is shown in FIG. 2 , the scan 200 may capture a portion of thesurface tissue 202, such as the skin and underlying fat and tissuelayers. The scan 200 may also capture a portion of the deep tissue 206,bone, tendon, organ, or other tissue that is below the target muscle106. Primarily, the scan 200 captures at least a portion of the targetmuscle 106, more specifically the target muscle tissue 206. Runningthroughout the muscle tissue 206 are various non-muscle tissues 208,such as but not limited to connective tissues, tendon tissues, andvascular tissues.

As the scan 200 presents at least a cross section of the muscle tissue206, it is understood and appreciated that non-muscle tissue 208 that istruly within, connected to, or in contact with the muscle tissue 206 mayappear as part of, or otherwise within the muscle tissue 206. For thepurposes of non-invasive fuel determination as set forth herein,non-muscle tissues 208 that appear within the scan 200 of the muscletissue 206 may be considered to be part of the muscle tissue 206.

Fuel 210 within the muscle tissue 206 are shown in FIG. 2 and in theaccompanying figures as dots, with dot 212 being exemplary. Forconceptual illustration and ease of discussion, the larger the fuelamount 210 the larger the dot 212. It is to be understood andappreciated that muscle fuel 210 is naturally occurring within themuscle tissue 206. Moreover, the methods and systems disclosed hereinfor non-invasive determination of fuel 210 within a target muscle 106are advantageously distinct and directed to naturally occurring fuel210, not injected glycogen, creatine, carnitine, and the like, as hasbeen used to highlight internal structures and or features.

With respect to the development of fuel 210, carbohydrates are arguablythe most important source of energy for animals, and more specificallymammals including human beings. Once eaten, carbohydrates are brokendown into simple sugars such as glucose, fructose and galactose that areabsorbed by cells and used for energy. Glucose that is absorbed by amuscle cell but not immediately needed is stored as glycogen, i.e., acomponent of the fuel 210. Muscle conditioning and training can increasethe amount of muscle fuel 210. Whether through activity or simply thepassage of time between eating, drinking and/or otherwise receivingcarbohydrates, protein, creatine, etc., the fuel within muscles will bedepleted. In addition, other constituents of fuel also increase inmuscle based on healthy eating, conditioning and hydration, and aredepleted by exercise and time. As such, muscle fuel is not a staticparameter of muscle health, but rather a parameter that can be alteredby how the muscle is treated.

With respect to the ultrasound scan 200, fuel can be detected as one ormore attributes within the scan 200. More specifically, in many casesthe scan 200 is rendered to a user of an ultrasound scanning system asan image. The attributes of the image correspond to sonogram reflection.More specifically, in at least one embodiment the scan 200 isrepresented as an image with attributes represented as luminance, color,contrast and or combinations thereof.

Further, although the accompanying FIGS. 1, and 2, 5-11 and 13 depictthe scan 104 as an image, the interpretation of the scan 104 as an imagehas been chosen to facilitate ease of discussion and illustration.Indeed it is to be understood and appreciated that the varyingembodiments of systems and methods for non-invasive fuel detection,attributes of the scan 104 may be interpreted without rendering an imageto a user. Indeed, as is further discussed below other visual, audibleor tactile notifications can be used to signify the determined fuelvalues with or without displaying an image of the scan to a user.

Further, although the illustrations and discussion provided herein forexemplary purposes generally appear to be 2D (two dimensional) images,the system and methods are equally applicable multi-axis ultrasoundimaging techniques, such as for example 3D ultrasound.

FIG. 3 in connection with FIG. 1 provides a high level flow diagram withconceptual illustrations depicting a method 300 for non-invasivedetermination of fuel within a target muscle 106. It will be appreciatedthat the described method, as well as all other subsequent methods andrefinements to the disclosed methods need not be performed in the orderin which they are herein described, but that the descriptions are merelyexemplary of a method or methods that could be performed fornon-invasive fuel determination.

More specifically, as in FIG. 3 , for at least one embodiment, method300 commences with receiving an ultrasound scan 104 of at least aportion of a target muscle 106, block 302. With the scan 104 received,at least a portion of the ultrasound scan 104 is evaluated to determinethe fuel 210 within the target muscle 106, block 304.

For application of method 300, an embodiment of SNDGS 100 need not have,or otherwise be coupled to, an ultrasound transducer 126. Method 300 mayalso be performed by SNDGS 100 when a user desires to review historicaldata of target muscle scans, such as for example to revisit pasthistories of evaluation to perceive changes in development and potentialadjustments to a subject's training methods. In addition, as discussedmore fully below, historic data may be used to score a muscle's fuellevel or even provide a rating for the muscle, which may also changeover time.

Of course for real time and non-invasive determination of fuel, invarying embodiments SNDGS 100 may indeed include an ultrasoundtransducer 126 as described above. As such, method 300 may be augmentedas method 350, the augmentation as illustrated pertaining to at leastone method of providing the received ultrasound scan 104.

More specifically, for augmented method 350, an ultrasound transducer126 is provided as part of SNDGS 100, block 352. A target muscle, e.g.target muscle 106, is selected, block 354. As noted, the ultrasoundtransducer has an adjustable depth for scanning, such as a selectionbetween about 0.5 and 10 centimeters. The ultrasound transducer 126 isadjusted to provide a depth of scan appropriate for the selected targetmuscle, block 356.

In at least one embodiment, the depth of scan is adjusted manually, suchas to about 3.5 centimeters for the rectus femoris muscle. In analternative embodiment, the depth of scan is automatically selected byan operator selecting a muscle, e.g., rectus femoris, vastus lateralis,or biceps. In addition, in varying embodiment, the auto-determined andset depth may also be adjustable by the operator so as to permitadjustment for various body types.

In at least one embodiment additional and optional information about thesubject is recorded, as indicated by dotted block 358. This optionalinformation may include, but is not limited to, details such as thesubjects name, age, gender, time of day, status of subject—at rest/atVO₂ Max, after eating, or other such information desired to be recordedand displayed in connection with the scanned image of the target muscle.

Moreover, to summarize for at least one embodiment, the augmented method350 includes providing an ultrasound device having a movable transducer,the transducer operable in a high frequency range, selecting a targetmuscle 106 of a subject 110 and adjusting the ultrasound device for adepth of scan appropriate for the selected target muscle 106.

As the ultrasound transducer 126 operates by providing a high frequencysignal that is directed into tissue and detecting reflections returnedby encountered elements, it is understood and appreciated that thetransducer should be aligned generally perpendicular to the selectedtarget muscle. Of course, if a transducer having an alignmentconfiguration that is other than perpendicular is employed the specificalignment as intended for the transducer should be used.

Testing has determined it is substantially immaterial as to whether theultrasound transducer 126 is positioned along the longitudinal orlatitudinal axis of the muscle, or somewhere there between. However forgeneral alignment purposes and ease of operation, in general theoperator of the system will select ultrasound transducer 126 alignmentmatching to either the longitudinal or latitudinal cross-sectional axisof the target muscle 106.

Application of the ultrasound transducer 126 against the subject's skincan be a practiced skill, for if too much pressure is applied thetransducer may inadvertently compress the muscle tissue and therebyhamper the quality of the scan and the resulting evaluation of the fuel.However, an easy solution presents itself that substantially minimizesthe risk of transducer related compression of the tissue.

As shown by optional dotted block 360, the subject can simply tense hisor her target muscle 106. More specifically, if the subject acts totense the selected target muscle 106, the natural action of the musclecontraction causes the muscle to swell and thereby resist compression.The contracted and thereby enlarged target muscle 106 may also beadvantageous in providing an even clearer cross sectional scan then maybe obtained with a relaxed muscle.

In short, while the quality of the scan for the tensed or un-tensedtarget muscle 106 may be the same for an operator skilled in how muchpressure to apply, for the novice, as well as the skilled operator,tensing the target muscle 106 does not hamper the determination of fuel210 and may help ensure greater consistency of scans in a wide varietyof locations and settings. Indeed, for at least one embodiment, when themethod of scanning a target muscle 106 is performed, the subject willtense his or her target muscle 106 as a normal and expected part of thescanning process.

Moreover, to achieve the scan of the target muscle 106, the ultrasoundtransducer 126 is disposed proximate to the target muscle and as theultrasound transducer 126 is activated the target muscle 106 is scanned,block 362. In at least one embodiment the ultrasound transducer 126 isplaced in direct contact with the subject's skin. In at least onealternative embodiment, a protective cover, shield or even the subject'sclothing is disposed between the ultrasound transducer 126 and thetarget muscle 106.

In other words, to summarize for at least one embodiment, the augmentedmethod 350 continues with disposing the transducer proximate to thesubject 110 and perpendicular to the selected target muscle 106, andthen imaging the selected target muscle 106 by processing ultrasoundreflection received by the transducer to provide at least a partial scanof the selected target muscle 106. Many ultrasound transducers provideimages as cross sections of the tissues and structures whereas othersmay provide 3-D views. For consistency in analysis, in at least oneembodiment the operator of SNDGS 100 adopts a convention to scan atarget muscle along its long axis or short axis. For the majority of legand arm muscles the long axis is generally parallel to bone structureand the short axis is generally perpendicular to bone structure. Indeedin some embodiments, scans with SNDGS 100 may be performed substantiallycontemporaneously along both the long and short axis of a target muscle106 for enhanced comparison and analysis.

Method 350 then continues with the evaluation of the scan as discussedabove with respect to block 304. For at least one embodiment, it isunderstood and appreciated that the evaluation of the scan 104 isperformed about contemporaneously with the scanning of the target muscle106.

The determined fuel 210 is then reported to the operator, block 364. Thedetermined fuel may also be recorded for use in plotting the changes ina subject's fuel level over time, and or in response to variousdifferent points of exercise and conditioning as well as differentperiods of exertion such as in endurance activities. As will bedescribed in greater detail below, the determined fuel level may also beused to provide the subject with a fuel level, fuel rating, and energystatus.

In at least one embodiment, the evaluation of the scan to determine thefuel value in the target muscle 106, is based on the visual experienceof the operator performing the method 300, and or enhanced method 350with respect to a visual image provided by the scan. More specificallyan experienced individual can provide qualitative analysis of the fuelby visually determining an area of the cross section image to focus onand then evaluating that selected portion based on historicalexperience.

Methods 300/350 and or SNDGS 100 can advantageously be utilized by agreater audience of benefited parties where the evaluation is performedas an automated, or at least partially automated evaluation process.

FIG. 4 in connection with FIGS. 5-13 provides a high level flow diagramwith conceptual illustrations to further refine at least one embodimentof method 400 for evaluating at least a portion of the ultrasound scanto determine the fuel 210 within the target muscle 106. Again it isappreciated that the described method need not be performed in the orderin which it is herein described, but that this description is merelyexemplary of one method for non-invasive determination of fuel within atarget muscle.

More specifically, as FIG. 4 expands on FIG. 3 , initially a scan of atarget muscle 106 is received, block 302. An exemplary scan such as scan500 is shown in FIG. 5 . As previously shown and described with respectto FIG. 2 , scan 500 includes skin and or other surface tissue 202, deeptissue 204 and target muscle tissue 206, with elements of non-muscletissue 208. The muscle fuel 502 within scan 500 is conceptually shown tobe high by the use of large dots 504 providing a substantially darkappearance to the scanned portion of the target muscle tissue 206.

As described above, and not being bound by any one theory, muscle fuelincludes a number of water-bound constituents, like glycogen,building-block proteins, carnitine and creatine. In fact, each gram ofglycogen is tightly bound to three grams of water, such that watercontent of a muscle can be correlated to a glycogen content of a muscle.Further, other muscle fuel constituents are also tightly-bound to water,some at a one gram to one gram ratio, allowing not just glycogen, butmuscle fuel to be correlated with water content of a muscle. As furtherdiscussed herein, water allows sound waves to pass through withoutresistance and shows as hypoechoic (as compared to dense materials whichare hyperechoic), which allows for the development of fuel concentrationscales 506. Water, and therefore muscle fuel, is located in darker areasof an image, while lighter areas of an image are found to have lesswater and therefore less muscle fuel.

A pre-established fuel concentration scale 506 is also shown. Thepre-establishment of the fuel concentration scale 506 aids in theeffective identification of attributes that are correlated to the fuel,e.g., color, contrast, darkness, luminance and or combinations thereof.

In at least one embodiment, a precise reference of fuel values as agradient scale is established by contemporaneously taking an ultrasoundcross sectional image and a biopsy of the same target muscle atsystematic stages of exercise to exhaust the fuel, and or fuelreplenishment to re-establish the muscle fuel. The empirical data from aplurality of subject can establish an advantageous reference that isapplicable to many different subjects.

It is also understood and appreciated that in at least one embodiment,an even more precise predetermined reference can be established for aspecific subject by the contemporaneous imaging and biopsy process uponthat subject. Alternatively, a general fuel concentration scale 506 asestablished from one or more other subjects may be refined for aspecific subject based on repeated application of the methods300/350/400 and or SNDGS 100.

As shown the fuel concentration scale 506 covers a range. For ease ofillustration and discussion the exemplary range as shown is from 4 to 0.An actual range as applied in methods 300/350/400 and or in SNDGS 100may be greater or smaller. For purposes of the exemplary embodiments anddescription thereof, the valuation of 4 is appreciated to be a fuellevel of about 100% (e.g., the target muscle is at its maximum glycogenstore) and a valuation of 0 is appreciated to be a fuel level of about0% (e.g., the target muscle has depleted its glycogen store).

Moreover, as is further discussed below, the fuel scale—whetherpre-established for a specific subject, or based more generally upondata from a plurality of test subjects permits a user of SNDGS 100 toadvantageously and non-invasively determine the fuel within a targetmuscle 106. It should also be appreciated that this determination may bemade upon a subject in nearly any setting or environment. In other wordsSNDGS 100 may be used and the fuel determined in a real time setting,for example, where the subject either is about to engage in an enduranceactivity or is engaged in training for endurance activity.

To evaluate the fuel 502 within the muscle tissue 206, method 400proceeds by defining a plurality of regions within the scan 500. In atleast one embodiment the plurality of regions or parts are a pluralityof areas, block 402. These regions or areas can be defined in a varietyof ways.

For at least one embodiment, pre-existing scan elements are accepted asthe scan areas, as indicated by optional dotted block 404. In varyingembodiments these pre-existing scan elements are one or more scanpixels. Where the scan is treated as an image, scan pixels may correlatedirectly with image pixels and image pixels may be used as thepre-existing elements.

In an alternative embodiment, as shown in FIG. 6 the plurality of areasare defined by applying a grid 600 to the scan 500. For ease ofillustration and discussion the scan 500 is shown as an image, but it isunderstood and appreciated that the evaluating operation may beperformed by working with the scan 500 as an image or as simply data,neither of which is actually displayed to an operator.

To summarize, for at least one embodiment the evaluating of at least aportion of the ultrasound scan 500 includes defining a plurality ofareas within the ultrasound scan 500, each area having at least oneattribute.

As shown in FIG. 6 the grid 600 is conceptually illustrated as a 12×12grid for ease of illustration, thereby providing one hundred and fortyfour areas 602. In varying embodiments a larger or smaller grid may beapplied. As is further shown in FIG. 6 a subset of the areas 602 is thenselected, block 408.

Moreover, it is not unusual for the sides of the scan to be somewhatunclear, and as shown in FIGS. 5 and 6 there is both surface tissue 202and deep tissue 204 partially captured in the scan 500 in addition tothe desired muscle tissue 206. These undesired areas, of which area 604is exemplary, are therefore removed from further consideration asindicated by the presence of a circled-X in each undesired area.

If not previously set, at least one attribute of the areas 602 is thenselected, such as color, luminance, darkness, contrast or otheridentifiable attribute and/or combinations thereof, block 410. Moreover,the ultrasound scan as a data file may well contain information thatalthough highly beneficial and adaptable for the determination of fuelis blurred or otherwise rendered less clear when the scan is rendered asan actual image to an operator. As such, it is understood andappreciated that non-visual attributes as well as visual attributes mayalso be utilized alone or in combination with one another in varyingembodiments for the non-invasive determination of muscle fuel.

In at least one embodiment the attribute of comparison is hypoechoicappearance as opposed to hyperechoic (also known as echogenic)appearance. More simply stated the evaluation is a comparison of theattributes within an area 602 to a scale of black to white. Again forillustrative purposes the attribute selected in the present example isdot size.

With respect to FIGS. 5 and 6 , it is clear that the presence ofnon-muscle tissues 208 affect the apparent concentrations of fuel, e.g.,the dots, in some areas but not others. More specifically, exemplaryarea 606 is shown to have no non-muscle tissue 208 while exemplary area608 has a substantial non-muscle tissue 208 component. In at least oneembodiment, the identification and discounting of non-muscle tissue 208is achieved. Moreover this advantageous identification and discountingcan be achieved through the use of a threshold in area evaluation.

To simplify the initial walk through of method 400, initially thethreshold will not be set, decision 412.

Method 400 therefore proceeds to select an area 610 that has not beenremoved from further consideration, block 414. The attribute of thisarea 610 is then quantified as a value, block 416. More specifically theattribute of the selected area 610 is compared to the fuel concentrationscale 506 and an appropriate value assigned to the area 610, shown asthe value within the circle—a 3 in the case of area 610. For exampleexemplary area 606 is quantified as a 4 whereas exemplary area 608 isquantified as a 2.

Method 400 proceeds with a query as to whether there are remaining areasto be quantified, decision 418. If additional areas remain, a new areais selected, block 420 and the attribute(s) are again quantified, block416. In at least one embodiment, the selection of the next element isbased on a sweep operation, e.g., starting at the far left and movingacross an entire row before moving then to the next row and startingagain at the far left. This sweep methodology can of course be adaptedto move from right to left and from top to bottom or bottom to top ofcolumns. The sweep method of selection is merely exemplary and is not alimitation precluding alternative selection schemes. Indeed, in at leastone embodiment utilizing multiple processors and/or processes theselection and evaluation of all areas may be performed substantiallysimultaneously.

To summarize again, the evaluating of at least a portion of theultrasound scan 500 includes, for at least a subset of defined areas602, quantifying each attribute as a value from a predetermined range ofvalues.

With the attributes of all areas now quantified as values, the valuesare processed to determine a fuel value for the target muscle 106 asscanned and represented by scan 500, block 422. Collectively, the valuesassigned to the attributes represent a data set. For at least oneembodiment the processing of the values is an action to determine thecentral tendency of the data set.

Determining the central tendency of a set identifies the “center” of thedistribution of values within the sets. There are three general types ofestimates of central tendency and they are respectively, the mean, themedian and the mode. To compute the mean, it is generally understood totake the sum of the values and divide by the count. This is commonlyknown as averaging. The median is the score found at the middle of theset of values, which is to say that there are as many cases with alarger value as there are cases with a smaller value. The mode is themost frequently occurring value in the set, e.g., the value occurringwith the greatest frequency.

Other options for statistical measures of the values by processing themmay also be performed such as standard deviation and range. Even for anaverage, there are three common choices—arithmetic mean (sum divided bycount), the geometric mean (n member are multiplied together and thentaking the nth root), and the harmonic mean (for a set s of numbers a₁,a₂, . . . a_(a) it is the reciprocal of the arithmetic mean of thereciprocals of a/s).

For various embodiments, processing of the values may also include theapplication of a constant value or other formula. In general and for thevarying embodiments employing different forms of processing for thequantified values, the intent is to achieve a value that isrepresentative of the amount of fuel within the target muscle asrepresented by the scan of the muscle tissue.

In at least one embodiment the processing of the values is averaging thevalues, e.g., an arithmetic mean. Moreover, in FIG. 6 a table 612 isshown with columns A to L and rows 1 to 12 correlating to the definedareas 602 of scan 500. The quantified values of the selected attributefor each area are shown and the overall average is shown to be 3.38.Based on the fuel concentration scale 506 the determined value of 3.38at time X₁ is understood and appreciated to be a high fuel value.

The determined fuel value is then returned, block 424. In varyingembodiments the determined value may be returned to the operator as thequantified value, or as a representation of the value—such as but notlimited to color, sound, vibration, or combinations thereof as well asvarying intensity thereof.

Use of SNDGS 100 and or method 300/350/400 has many practicalapplications, not the least of which is to assist in athletic and/orendurance training. Another application is for rehabilitation wherein itis highly desirable to quantify how the muscle tissues are repairingand/or rebuilding. Further still, another application would potentiallybenefit incapacitated subjects, such as hospital patients, the infirm,the elderly or other persons who may for one reason or another havedifficulty communicating. As such, for at least one embodiment, themethod and or use of SNDGS 100 may be repeated over time upon the sametarget muscle 106.

FIGS. 7-9 conceptually illustrate repeated testing upon the same targetmuscle at time intervals of X during a subject's workout. As such, notonly do FIGS. 6-9 cooperatively work to demonstrate how the method andor use of SNDGS 100 can advantageously assist in establishing anunderstanding of a subject's fuel values over time during exercise, eachof FIGS. 6-9 when compared with the other FIGS. 6-9 also can help aid inunderstanding how the method and or use of SNDGS 100 can advantageouslyidentify the fuel within a target muscle 106 as the fuel itself likelyvaries in concentration within the target muscle.

Further too, it will be observed that the non-muscle tissue 208 variesfrom location to location as between FIGS. 6-9 . Moreover the methodsand or use of SNDGS 100 can provide a non-invasive determination of fuelwithin a target muscle 106 even as the scan of the target muscle 106 mayvary somewhat from one scan to the next.

Moreover, at the second time interval X₂, as shown in the scan 700 ofFIG. 7 , the fuel 502 in the deeper portion 750 of the target muscle 106is still generally high. The fuel 502 in the outer portion 752 of thetarget muscle 106 tissue are beginning to diminish. Indeed prior to theonset of testing of the methods disclosed herein, it was unknown as towhether fuel depleted evenly throughout, from the outside in or theinside out.

Indeed, although a biopsy of the target muscle can be performed todetect glycogen (or other like energy constituents), based on thepreliminary findings from test applications of this method it is clearthat even a biopsy could be misleading—for if the biopsy is taken fromtoo deep or too shallow a location within the target muscle, the samplemay or may not accurately represent an overall evaluation of the targetmuscle as a whole. For at least one embodiment where a biopsy isperformed contemporaneously with the scan of a target muscle such as toestablish a baseline for a given subject, the location of the biopsywithin the scan is noted so as to correlate the results of the biopsy toa specific area of the scan and thereby permit relative valuation to theother areas of the scan, e.g., areas 602, 702, 802, 902 based on theresults of the biopsy.

Advantageously, and quite distinct from the biopsy, as the entire methodis performed as a non-invasive process, there is no insult to the targetmuscle and therefore no real prospect of the test itself hamperingperformance. Further still, it is possible to quickly and easily comparein near real time the fuel values of different muscles, e.g. thesubject's right rectus femoris muscle and the subjects left rectusfemoris muscle. Such information may be highly advantageous during therehabilitation of a muscle or group of muscles.

In other words, the method and or use of SNDGS 100 can enhance theevaluation of fuel within the target muscle that cannot easily beachieved, if at all matched strictly with muscle biopsy.

As with FIG. 6 , a grid 600 has been applied to the scan 700 to define aplurality of areas 702 within the scan 700. Fuel 502 is againrepresented as dots of varying sizes. Undesirable areas, of which area704 is exemplary, are again removed from consideration as indicated bythe circle-X.

In accordance with the application of method 400, an area, such asexemplary area 706 is selected and the attributes of this area 706 arecompared to the fuel concentration scale 506 and an appropriate valueassigned to area 706, blocks 414 and 416. For example, exemplary area706 is quantified as a 3 whereas exemplary area 708 is quantified as a4.

Again, method 400 proceeds with a query as to whether there areremaining areas to be quantified, decision 418. If additional areasremain, a new area is selected, block 402 and the attribute(s) are againquantified, block 416.

As in FIG. 6 , with the attributes of all areas now quantified asvalues, the values are processed to determine a fuel value for thetarget muscle 106 as indicated by scan 700. In at least one embodiment,the processing of the values is averaging the values. Moreover, in FIG.7 a table 710 is shown with columns A to L and rows 1 to 12 correlatingto the defined areas 702 of scan 700. The quantified values of theselected attribute for each area are shown and the overall average isshown to be 2.99, and indeed a reduction from the scan 500 at time X₁.

In FIG. 8 representing scan 800 at time interval X₃, brief observationindicates that both the deeper portion 850 and the outer portion 852 ofthe target muscle 106 are showing decreased fuel amounts 502.

As with FIGS. 6 and 7 a grid 600 has been applied to the scan 800 todefine a plurality of areas 802 within the scan 800. Undesirable areas,of which area 804 is exemplary, are again removed from consideration asindicated by the circle-X.

Again in accordance with the application of method 400, an area, such asexemplary area 806 is selected and the attributes of this area 806 arecompared to the fuel concentration scale 506 and an appropriate valueassigned to area 806. For example, exemplary area 806 is quantified as a2 whereas exemplary area 808 is quantified as a 1.

Again, method 400 proceeds with a query as to whether there areremaining areas to be quantified, decision 418. If additional areasremain, a new area is selected, block 402 and the attribute(s) are againquantified, block 416.

As in FIGS. 6 and 7 , with the attributes of all areas now quantified asvalues, the values are processed to determine a fuel value for thetarget muscle 106 as indicated by scan 800. In at least one embodimentthe processing of the values is averaging the values. Moreover, in FIG.8 a table 810 is shown with columns A to L and rows 1 to 12 correlatingto the defined areas 802 of scan 800. The quantified values of theselected attribute for each area are shown and the overall average isshown to be 1.8, and indeed a reduction from the scan 700 at time X₂.

In FIG. 9 representing scan 900 at time interval X₄, brief observationindicates once again that both the deeper portion 950 and the outerportion 952 of the target muscle 106 are showing decreased fuel 502.

Once again, as with FIGS. 6, 7 and 8 a grid 600 has been applied to thescan 900 to define a plurality of areas 902 within the scan 900.Undesirable areas, of which area 904 is exemplary, are again removedfrom consideration as indicated by the circle-X.

Again in accordance with the application of method 400, an area, such asexemplary area 906 is selected and the attributes of this area 906 arecompared to the fuel concentration scale 506 and an appropriate valueassigned to area 906. For example, exemplary area 906 is quantified as a0 whereas exemplary area 908 is quantified as a 1.

Again, method 400 proceed with a query as to whether there are remainingareas to be quantified, decision 418. If additional areas remain, a newarea is selected, block 402 and the attribute(s) are again quantified,block 416.

As in FIGS. 6, 7 and 8 with the attributes of all areas now quantifiedas values, the values are processed to determine a fuel value for thetarget muscle 106 as indicated by scan 900. In at least one embodiment,the processing of the values is averaging the values. Moreover, in FIG.9 a table 910 is shown with columns A to L and rows 1 to 12 correlatingto the defined areas 902 of scan 900. The quantified values of theselected attribute for each area are shown and the overall average isshown to be 0.54, and indeed an even further reduction from the scan 800at time X₃.

With respect to FIGS. 6-9 , it is understood and appreciated that assubstantially the same grid 600 is applied to each scan, e.g., scans500, 700, 800 and 900, the same number of areas are defined within eachscan, and the size of the defined areas is generally constant from onescan to the next. This consistency remains and is not affected bydifferent locations of the scan. Certainly for consistency it isdesirable for the operator to attempt to be close and perform each scanin approximately the same location—but slight variation of location isnot detrimental.

In addition, in FIGS. 6-9 and with respect to the evaluating operationof method 400, it has been noted above that undesirable areas areremoved from consideration. In at least one embodiment, the selection ofthe subset of areas for quantified valuation is an automated process.More specifically, as shown in FIG. 10 , in at least one embodiment theselection of the portion 1000 for evaluation is determined based uponthe center 1002 of the scanned image of the target muscle 106. Inalternative embodiments, the portion 1000 could also be offset from thedetermination of the skin and outer tissue layers or by other generallyestablished reference point.

In at least one alternative embodiment, the selection of the portion forevaluation is user adjustable and or definable. More specifically, forat least one embodiment as shown in FIG. 11 , the operator can indicateby a drawn line 1100 the boundary for the selected portion forevaluation. In yet other alternative embodiments, line 1100 may beachieved by stretching and otherwise altering the initial automatedselection, such as portion 1000 in FIG. 10 .

FIG. 12 presents a chart 1200 of the determined fuel for times X₁ to X₄as shown in FIGS. 6 to 9 . Such testing and the resulting chart 1200 canbe an advantageous tool in athlete conditioning. For example, use of themethod and or SNDGS 100 prior to the onset of training and duringtraining can assist the athlete subject in maximizing his or hertraining efforts, for attempting to exercise or compete with diminishedfuel can accelerate muscle breakdown, increase the possibility ofinjury, and potentially subject the subject to other undesirableconditions.

Moreover, application of the methods and or SNDGS 100 can help determinewhether the subject should eat more carbohydrates, drink more water,take energy supplements before exercising or competing, whether his orher fuel amounts are good and further eating would only divert bloodfrom the muscles to the stomach for digestion, and or whether despiteeating the subject's muscles are not in an optimal condition forexercise or competition and rest should be enjoyed.

Further, as SNDGS 100 permits substantially real time analysis of musclefuel, a base line for a subject's metabolism and conversion of foods tofuel stores can be established. More specifically, by having a subjecteat food, such as but not limited to bread, fruit, energy supplementssuch as gels, formulated bars, etc. . . . and scanning one or moretarget muscles during and after the consumption, SNDGS 100 permits thesubject to advantageously know his or her precise conversion scale for“X” grams of carbohydrates (for example) to a “Y” valuation of fuel in agiven amount of time.

Such knowledge of how many grams of carbohydrates equate to a maximumfuel storage value, and/or the replenishment of that value is highlyadvantageous in many settings. A coach can monitor and adjust the foodintake of his or her individual or team athlete(s), but so too canmilitary personnel better prepare for mission critical situations. Morespecifically, by forecasting the duration of a mission and the level ofexertion during that mission, a commander can accurately predict howmuch food each member of the team should have, for too little and themission may suffer due to fatigue or lack of optimum performance and toomuch may adversely add unnecessary bulk and weight to a team that isstriving to move with speed and stealth. The same can be said for theamount of water that should be ingested to maximize fuel intake valuesto the muscle. Users of the embodiments herein can monitor any number ofparameters to optimize performance and maximize fuel amounts in targetmuscles.

As SNDGS 100 and/or methods 300/350/400 permit the determination of fuelvalues within one or multiple muscles, it will be appreciated that SNDGS100 and methods 300/350/400 may be adapted so as to identify for atarget muscle a target fuel score. In addition, different muscles withina subject's body may be better indicators of muscle fuel values thenothers and this too may be determined. For example in subject A, themuscle of interest may be his left bicep, but his left vastus lateralisis a better indicator muscle. For subject B, the muscles of interest maybe both the left and right vastus lateralis, but the right rectusfemoris is a better indicator muscle. This may be due to differences inthe size of the muscles and or differences in person to personphysiology.

Although it is certainly possible to exercise one muscle and not anotherand thereby reduce the fuel within one muscle but perhaps not assignificantly in other muscles, the re-development of fuel within themuscles, especially when at rest—is a process based on the circulatorysystems delivery of nutrients and is therefore generally balancedthroughout the body. Indeed, although all muscles fuel values areindependent of one another, all of the muscle fuel do relate to thetotal fuel in the body.

As such, identifying different ranges for fuel in different muscles canassist in better evaluating the fuel values in one or more desiredmuscles. More simply stated, one or more indicator muscles may beidentified within a subject's body and may then be used to betterevaluate the subjects muscle fuel values both individually and withrespect to the total body muscle fuel.

FIG. 19 presents a flow diagram for a method 1900 in accordance with atleast one embodiment for determining a target fuel score. As indicatedit is most ideal to scan the target muscle before and after nutrition aswell as before and after exercise so as to develop a more complete fuelprofile for the target muscle. Method 1900 commences by scanning atarget muscle as described above to receive an ultrasound scan, block1902. The scan is then evaluated as described above so as to determine afuel value, block 1904. The fuel value is then recorded as an element ofa data set for the target muscle, block 1906. Whereas the abovedescription utilized a range of 4 to 0 for ease of discussion andillustration, for at least one embodiment the range is 10 to 0, 50 to 0,and can also be 100 to 0.

Determination of a target score is facilitated by multiple scans so asto provide a greater identified range of potential muscle fuel valuesfor the target muscle. As such for at least one embodiment, method 1900queries the number of scans that have been performed, decision 1908. Forat least one embodiment, if the number of scans is less than 5, method1900 repeats for additional scans before continuing. Moreover, a singledata point representing a fuel value is not generally sufficient byitself to define a range. Two different data points can define a range,but as the number of data points increases so too does the precisenature of the range.

If a sufficient number of scans have been performed, method 1900continues by evaluating the data set to develop a range of fuel values,block 1910. Determination of a target score is facilitated by having aviable range, such as values spanning a pre-determined range. For atleast one embodiment, the pre-determined range is equal to or greaterthan 10. If the determined range of actual values in the data set isless than the pre-determined range, method 1900 returns to collect morescans, decision 1912. In other words, for at least one embodiment method1900 requires at least 5 scans as well as a range of at least 10 asdefined by the at least five scans. If either condition is not true,method 1900 continues to collect additional scans until the conditionsare satisfied. Of course it is understood and appreciated that invarying embodiments, a greater or lesser number of scans and a greateror lesser range may be adopted.

In the event that the ranges of values in the data set is equal to orgreater than the pre-determined range, decision 1912, method 1900advances to determining a target score based on an upper portion of thedetermined range, block 1914.

For at least one embodiment, evaluating the data set may be described asproviding a statistical summary for the fuel value data set. Moreover,for at least one embodiment, the evaluation of the data set, block 1910,is more fully appreciated by the determination of quartile values andthe use thereof.

FIG. 20 illustrates a plot 2000 of an exemplary data set 2002 of datapoints 2004 for an exemplary muscle, Muscle A, and a plot 2050 of anexemplary data set 2052 of data points 2054 for an exemplary muscle,Muscle B. As shown for Muscle A, there are nine data points 2004A-20041representing muscle fuel scores as determined from ten differentscanning sessions. Muscle B has seven data points 2054A-2054G, defininga smaller plot 2050.

As illustrated, in at least one embodiment, the data set is divided intohalves based on the median value (Q2 2006) of the data set, block 1916.A lower quartile value (Q1 2008) is determined as the median of thelower half of the data set, block 1918. An upper quartile value (Q32010) is determined as the median of the upper half of the data set,block 1920. An inter-quartile range (IQR 2012) is then established asthe difference between Q3 2010 and Q1 2008, block 1922.

Depending on the actual elements of the data set 2002, Q3 2010 and Q12008 may or may not match to one or more actual elements of the data set2002. Accordingly within the IQR 2012, the fuel value (FGV) equal to orabove Q1 2008 is identified, block 1924. In FIG. 20 , this is data point2004A. Similarly, the fuel value (SGV) equal to or just below Q3 isidentified, block 1926.

In FIG. 20 , this is data point 2004E. A lower fence value 2014 isestablished as, Lower Fence=FGV−1.5 (IQR), block 1928, and an upperfence value 2014 is established as, Upper Fence=SGV+1.5 (IQR), block1930. Data points correlating to muscle fuel values that are above theupper fence 2016 or below the lower fence 2014, such as data points2004F and 20041, are considered outliers and therefore discounted.

The range 2018 of fuel values for the target muscle is then establishedas the maximum and minimum actual fuel values within the upper and lowerfences (e.g. fuel value data point 2004H and fuel value data point2004G, block 1932). Of course it is understood and appreciated that invarying instances, actual data points may indeed correspond with theupper fence, the lower fence or both, such as is shown in the plot 2050for Muscle B. For at least one embodiment, the target score, representedas a diamond 2020, for the target muscle is established as Q3 2010. Ofcourse as additional scans are performed over time and as additionaldata points for determined fuel scores are added as elements to the dataset, the precision of the defined range 2012 will be improved, as willthe true value of Q3 2010.

The statistical summary of the data set for the target muscle may bedisplayed to a user as a box plot 2000 as shown in FIG. 20 . As shown byFIG. 20 , very quickly the use can appreciate the range 2018 of likelyfuel values as well as the target score 2014. The data points thatcomprise the IQR are important because they not only determine the IQRvalues, but also the upper and lower fences.

To summarize, for at least one embodiment, determining a target fuelscore 2020 for a target muscle includes receiving an ultrasound scan ofa target muscle; evaluating at least a portion of the ultrasound scan todetermine fuel value within the target muscle; recording the determinedfuel value for the muscle as an element of a data set 2002 for themuscle; evaluating the fuel data set 2002 to determine a value range2018; and in response to the range 2018 being at least above apre-determined threshold, establishing a target score 2020 for themuscle as based on an upper portion of the value range. This value willbe referred to as the fuel value for the muscle.

It should also be understood and appreciated that method 1900 may beperformed in a somewhat historical fashion, wherein a plurality ofexisting scans for a target muscle over a plurality of ultrasoundsscanning sessions are received and evaluated collectively. Moreover forat least one alternative embodiment determining a target fuel value 2020for a target muscle includes receiving from a subject a plurality ofultrasound scans of a target muscle over a plurality of ultrasoundscanning sessions; for each received ultrasound scan, evaluating atleast a portion of the ultrasound scan to determine fuel value withinthe muscle, the collective fuel values being a fuel value data set 2002for the muscle; evaluating the fuel value data set 2002 to determine avalue range 2018; and in response to the range 2018 being at least abovea pre-determined threshold, establishing a target score 2020 for themuscle as based on an upper portion of the value range.

As noted above, for a given subject different muscles may be betterindicators of fuel levels then other muscles. For at least oneembodiment, a similar scanning and evaluation process as described abovewith respect to method 1900 and FIG. 20 is performed upon the subjectwith respect to a plurality of difference muscles. This plurality ofmuscles may be based upon the nature of the subjects sport orconditioning, or may be based more generally on a collection ofdifferent major muscle groups. Moreover, for each muscle scanned, eachscanned muscle is a target muscle for that scan.

Determining an indicator muscle may be an operation that is performedindependently from the determination of a target score. As such for atleast one embodiment, optional method 1950 commences with the scanningof multiple muscles as described above to determine a plurality of fuelvalues, each associated with a specific muscle, block 1952. Thedetermined fuel value of each muscle is recorded to a database as anelement of a data set associated with each muscle. Whereas the abovedescription utilized a range of 4 to 0 for ease of discussion andillustration, for at least one embodiment the range is 100 to 0. Onceagain, it is most ideal to scan the muscles to occur before and afternutrition as well as before and after exercise so as to develop a morecomplete fuel profile for each of the scanned muscles.

Determination of an indicator muscle is facilitated by multiple scans soas to provide a greater identified range of potential muscle fuel valuesfor each of the scanned muscles. As such for at least one embodiment,method 1950 queries the number of scans that have been performed foreach muscle, decision 1954. For at least one embodiment, if the numberof scans is less than 5, method 1950 repeats for additional scans ofeach muscle before continuing.

If a sufficient number of scans have been performed, method 1950continues by evaluating the data set for each muscle to develop a rangeof fuel values for each muscle, block 1956. As the different muscles arebeing compared to one another so as to identify an indicator muscle, inat least one embodiment it is not necessary that each scanned musclehave a viable range of values spanning a pre-determined range as in theabove case of determining a target score value.

The evaluated ranges are then ordered, or otherwise ranked to oneanother based on range spread, block 1956. And at least the muscle withthe greatest range is selected as an indicator muscle, block 1960. It isunderstood and appreciated that if the specific muscle of interest isdifferent from the indicator muscle, the desired muscle is notnecessarily ignored. While scanning of the determined indicatormuscle(s) may be sufficient in some situations to assess general musclefuel, and may be sufficient in some situations, in others the use of theof at least one indicator muscle is combined with the evaluation of thedesired muscle so as to enhance the evaluation of the fuel within thedesired muscle. In other words, the indicator muscle may be used as abaseline for evaluating a muscle fuel value in a different muscle.

For at least one embodiment, evaluating the data sets may be describedas providing a statistical summary for the fuel value data sets.Moreover, for at least one embodiment, the evaluation of the data sets,block 1956, is more fully appreciated by the determination of quartilevalues and the use thereof. Moreover, in at least one embodiment, theevaluation of the data sets includes for each data set the stepsdescribed above as blocks 1916-1932 for the determination of Q2, Q3,IQR, a lower fence and an upper fence. In addition, for each muscle atarget score may also be identified as Q3.

FIG. 21 presents an exemplary set of box plots established for aplurality of muscles so as to identify at least one indicator muscle toassist with the evaluation of a target muscle. These box plots representscans for the Right FF (Right Forearm Flexors), Right RF (Right RectusFemoris), Left RF (Left Rectus Femoris), Left GS (LeftGastrocnemius/Soleus), Right IN (Right Infraspinatus), and Right GS(Right Gastrocnemius/Soleus). As shown, the box plot 2100 for the RightFF muscle has the greatest range and is selected as an indicator muscle.

For the exemplary subject who's muscles are reflected in FIG. 21 ,general muscle fuel in his or her body may be quickly gauged by a scanof the Right FF as the indicator muscle. For evaluation of a specificdesired muscle, such as the Left RF, shown to be box plot 2101, the scanof the desired muscle and the associated box plot may be compared withthe scan and box plot of the indicator muscle. Moreover, for each musclescanned the present value of the determined fuel value can be displayedupon the associated box plot for advantageous visual comparison andevaluation.

To summarize, for at least one embodiment, determining at least oneindicator muscle for determination of muscle fuel, comprising: selectingfrom a subject a plurality of different muscles to establish a pluralityof fuel value data sets, each data set established by; receiving anultrasound scan of each muscle; evaluating at least a portion of theultrasound scan to determine fuel value within the muscle; recording thedetermined fuel value for the muscle as an element of a fuel value dataset for the muscle; evaluating each fuel value data set to determine arange for each muscle; ranking the scanned muscles by determined range;and selecting at least the highest ranked muscle as at least oneindicator muscle.

It should also be understood and appreciated that method 1900 may beperformed in a somewhat historical fashion, wherein a plurality ofexisting scans for a plurality of different muscles over a plurality ofultrasounds scanning sessions are received and evaluated collectively.Moreover for at least one alternative embodiment determining at leastone indicator muscle for determination of muscle fuel value, comprising:receiving from a subject a plurality of ultrasound scans from aplurality of different muscles over a plurality of ultrasound scanningsessions; for each received ultrasound scan of each muscle, evaluatingat least a portion of the ultrasound scan to determine fuel value withinthe muscle, the collective fuel values being a fuel value data set forthe muscle; evaluating each fuel value data set to determine a range foreach muscle; ranking the scanned muscles by determined range; andselecting at least the highest ranked muscle as at least one indicatormuscle.

Moreover, it is understood and appreciated that methods 1900 and 1950are for at least one embodiment, integrated as components of SNDGS 100and/or methods 300/350/400. For at least one alternative embodiment,methods 1900 and 1950 are additional capabilities that may be separatelyengaged by SNDGS 100 and/or methods 300/350/400. For yet at leastanother embodiment, methods 1900 and 1950 are incorporated as specificcapabilities for specific embodiments of SNDGS 100 and augmentations ofmethods 300/350/400. In other words, the identification of a targetscore for a target muscle and/or the identification of indicator musclesmay be additional features provided for some enhanced embodiments.

Moreover, SNDGS 100 and/or methods 300/350/400/1900/1950 are for atleast one embodiment adapted as a method of endurance conditioning for asubject. Specifically, during periods of endurance activity a coach,therapist, trainer, or other person—including the subject, can scan oneor more target muscles at a plurality of intervals. Typically the firstinterval would be just before starting or at about the onset of theactivity. By tensing the target muscle as noted above, a greatconsistency for the scan and evaluation is easily achieved. Based on thescan and its evaluation the endurance activity may be adjusted—such asto increase the level of activity, decrease the level of activity orperhaps even halt the endurance activity all together.

As the ultrasound scanning process is quick, and can be performed withhand held devices, discussed further below, SNDGS 100 and/or methods300/350/400/1900/1950 can be performed in the field of the enduranceactivity. In other words the subject does not have to travel to aspecific facility or location for the scanning and evaluation to beperformed. For example a cyclist can pause on a trainer or even holdonto a moving car to permit the scan of a target leg muscle. A swimmermay rest at the edge of the pool or hop out briefly to permit the scanof a target muscle. A runner may pause on a treadmill or stop on theside of the road. A football, soccer, or other field athlete may permita scan while he or she is out of rotation. A patient undergoing rehabmay be scanned during the rehab. Moreover, the fuel levels of a subjectmay be non-invasively determined in a setting where such determinationis highly advantageous and contemporaneously applicable to theperformance of the endurance activity.

Returning to the FIGS. 5-9 and the evaluating operation as shown in FIG.4 , it is once again noted that throughout the muscle tissue 206 areelements of non-muscle tissue 208, such as but not limited to connectivetissue, vascular tissue, scar tissue, foreign objects, etc. . . . In theinitial review of method 400 it was noted that identifying anddiscounting of non-muscle tissue could be achieved and would likelyenhance the precision for the determination of the fuel within thetarget muscle 106.

Returning to FIG. 4 , and FIG. 6 , in at least one embodiment thiselimination of non-muscle tissue 208 is achieved through the applicationof a threshold in the area evaluation. For the initial pass, a thresholdshould to be set, decision 412. For at least one embodiment, thethreshold may be a user provided value.

Establishing a threshold from the scan itself may be advantageous as thethreshold is then individually determined from the scan and can varyfrom scan to scan, muscle to muscle, subject to subject etc. . . . whilestill maintaining high precision for evaluation.

In at least one embodiment where the threshold is individuallydetermined from the scan, the method 430 of initializing the thresholdsubstantially parallels the above description for the generaldetermination of the fuel value with respect to block 410-block 418.

Moreover, the method 430 proceeds to select an area 602 that has notbeen removed from further consideration, block 432. The attribute ofthis area 602 is then quantified as a value, block 434. Morespecifically the attribute of the selected area 602 is compared to thefuel concentration scale 506 and an appropriate value assigned to thearea 602. For example exemplary area 606 is quantified as a 4 whereasexemplary area 608 is quantified as a 2.

The method 430 of initializing the threshold proceeds with a query as towhether there are remaining areas to be quantified, decision 436. Ifadditional areas remain, a new area is selected, block 438 and theattribute(s) are again quantified, block 416.

With the attributes of all areas now quantified as values, the valuesare processed to determine a fuel for the target muscle 106 as scannedand represented by scan 500, block 422. In at least one embodiment theprocessing of the values is averaging the values. Moreover, in FIG. 6 atable 612 is shown with columns A to L and rows 1 to 12 correlating tothe defined areas 602 of scan 500. The quantified values of the selectedattribute for each area are shown and the overall average is shown to be3.38.

Although the threshold can be set to be the overall average, asdifferent areas have different concentrations of fuel due to thepresence or absence of non-muscle tissue 208 as well as state of themuscle tissue itself, in general for at least one embodiment thethreshold is established as a percentage of the initial average value,block 440, such as for example 80%. Moreover, for at least oneembodiment, evaluated areas having an attribute value of at least 3.07(80% of 3.38) are considered muscle tissue while areas having anattribute value of less than 3.07 (80% of 3.38) are considerednon-muscle tissue 208 and therefore eliminated from furtherconsideration.

With a threshold so established, as each area is quantified under block416, the quantified value is now compared to the threshold, inaccordance with method refinement 450. For an embodiment where the samethreshold is to be applied for the entire scan, the previouslydetermined threshold is used, decision 452 and block 454. As will befurther explained momentarily, in at least one alternative embodimentthe threshold is adaptively varied, and more specifically is based thevalues of proximate areas, decision 452 and block 456.

Where the value of the attribute is above the threshold, e.g., greaterthan 3.07 (80% of 3.38), decision 458, the area and its associated valueis maintained, block 460. Where the value of the attribute is below thethreshold, e.g. smaller than 3.07 (80% of 3.38), decision 458, the areaand its associate value are discarded, block 462. Moreover it isunderstood and appreciated that the value of the attribute is comparedto the threshold. Incidental variations of the method to keep the valueif equal to or above in one embodiment or to discard if equal to orbelow in an alternative embodiment are within the scope of thismethodology.

For the example of FIG. 6 there are nine (9) areas with evaluatedattributes rated as 2. For ease of identification, these instances havebeen bolded and centered in table 612. Eliminating these nine valuesleaves ninety one remaining values that are above the threshold, andpermits a refined fuel score evaluation of 3.90.

Whereas FIGS. 5 and 6 conceptually show the fuel within the muscletissue to be generally uniform, FIGS. 7-9 conceptually show the fuelwithin the muscle tissue as being more variable, as application of themethods has so determined in repeated testing. As such, it isadvantageously beneficial for the threshold in at least one embodimentto be variable.

As suggested by the method refinement 450 for threshold evaluation,initially the threshold can be based on the previously determinedgeneral threshold for the entire scan. However, in at least oneembodiment an adjustable cache for the values of areas proximate to thecurrent area being evaluated is established. Until the cache isestablished, e.g., for the first few passes of evaluation, decision 452,the initial threshold value is used, block 454.

In varying embodiments this cache may be for areas in the same row (Nelements before, after or on either side), areas in the same column (Melements above, below or on either side), areas in the same gridsubsection (M elements by N elements including the currently selectedarea), and or combinations thereof. How the cache of proximate values isestablished—above, below, before, after, around—is largely dependent onhow the areas of the scan are selected for evaluation. In addition, thenumber of values that may be maintained in the cache is at least in partdetermined by the defined size of each area.

With respect to the method refinement 450 for threshold evaluation, ifthe value is above the threshold, decision 458 the area and its valueare kept, but the value may also be added to the proximate value cache,consisting of N members. As new members are added, old members arediscarded, and in this way the proximate value cache maintains aconsistent record of values for proximate areas.

Moreover, when the next area is selected, block 420 of the evaluationoperation method, as the proximate cache has been established, thethreshold is based on the proximate value cache, block 456. As before,in at least one embodiment, the threshold is a percentage of theproximate value cache. By adopting a percentage, some degree offluctuation between areas is permitted, but a sudden change will standout as tissue substantially unlikely to be muscle tissue.

FIG. 13 conceptually illustrates a scan 1300 of a target muscle 106. Aswith FIGS. 5-9 , fuel 502 within the muscle tissue 206 are representedas dots of varying sizes. As shown in scan 1300 the deeper portion 1350of the target muscle 106 has a greater apparent fuel amount 502 then theouter portion 1352 of the target muscle. As such, if a constantthreshold was applied in the evaluation, areas in the outer portion 1352might be inadvertently discounted and areas of the deeper portion 1350might be inadvertently included, and or vis-a-versa depending on thevalue of the threshold.

An enlarged first section 1302 is shown for the deeper portion 1350.Within this enlarged section a plurality of areas 1304 are shown. Theseareas include muscle tissue 206, but also in some instances non-muscletissue 208. The scale of the areas is such that as shown each area ispredominantly either muscle tissue 206 or non-muscle tissue 208. Withrespect to the fuel concentration scale 506, the attributes of the areasof predominant muscle tissue are defined as “3” whereas the attributesof the areas of non-muscle tissue are defined as “0.”

By way of example to demonstrate the application of the proximate cachevalue, attention is directed to example row 1306, and currently selectedarea 1308. The proximate value cache from the two areas immediately tothe left of area 1308 are 3. As the attributes of area 1308 are alsoevaluated as a 3, the value of area 1308 is above the threshold,regardless of what percentage is used. Area 1308 and its value are thenkept for the overall fuel determination and the value is also added tothe proximate value cache, block 460. If the cache is full, the oldestvalue is discarded and the new value is added.

The selection of the next area is then area 1310. In this case theattributes are evaluated as, for example 0.2. If the threshold is set as80% of the proximate value cache (e.g., 3), the threshold would be2.4—well above the 0.2 of area 1310. Area 1310 is therefore discarded asbeing very likely non-muscle tissue 208, block 462. The same is true forthe next area 1312. However, for the next area 1314 the attributes areevaluated as 2.8 (not shown on FIG. 13 ) which is above the threshold.Area 1314 is kept and the proximate value cache updated once again,block 460.

Moreover, with a sufficiently fine granularity of defined areas and areasonable proximate value cache, non-muscle tissue 208 can bestatistically identified and eliminated with a reasonable degree ofaccuracy.

Turning now to the enlarged second section 1320 for the outer section,it is clear that areas 1322 are of substantially the same size as areas1304 shown in the enlarged first section 1302. It is also visuallyapparent that with respect to the fuel concentration scale 506 theattributes of the areas of predominant muscle tissue for the enlargedsecond section 1320 are defined as “1” and again the attributes of theareas of non-muscle tissue are defined as “0.”

To parallel the above example, for enlarged second section 1320attention is directed to example row 1324, and currently selected area1326. The proximate value cache from the two areas immediately to theleft of area 1326 are 1. As the attributes of area 1326 are alsoevaluated as a 1, the value of area 1326 is above the threshold,regardless of what percentage is used. Area 1326 and its value are thenkept for the overall fuel determination and the value is also added tothe proximate value cache, block 460. If the cache is full, the oldestvalue is discarded and the new value is added.

The selection of the next area is then area 1328. In this case theattributes are evaluated as, for example 0.1. If the threshold is set as80% of the proximate value cache (e.g., 1), the threshold would be 0.8.While the difference between the areas value and the threshold is not asgreat as the similar example of the enlarged first section 1302, it isstill below the threshold and therefore discarded as being very likelynon-muscle tissue 208, block 462. The same is true for the next area1330. However, for the next area 1332 the attributes are evaluated as0.9 which is above the threshold. Area 1332 is kept and the proximatevalue cache updated once again, block 460.

To summarize the threshold for the enlarged first section 1302 is 2.4whereas the threshold for the enlarged second section 1320 is 0.8, andeach threshold is effective for its proximate location. Moreover, for atleast one embodiment, a first part 1302 of the scan 1300 of the targetmuscle 106 has a first threshold value and a second part 1320 of thescan 1300 of the target muscle 106 has a second threshold value. Foreach, the threshold value is determined from a cache of neighboring areaattribute values.

With respect to applications of SNDGS 100 and or methods300/350/400/1900/1950, for training, conditioning, rehabilitation orother purpose, it should be understood and appreciated, that the fuel ofmore than one target muscle 106 can be determined. Moreover, the samemuscle type, e.g. rectus femoris, vastus lateralis, biceps, etc. . . . ,may be targeted in both the left and right legs or left and right arms,chest or back for comparison, and or different muscles from differentareas may be compared, as is discussed further below. Further still, foreach muscle there is also generally a long axis and a short axis, i.e.,parallel to the subject's leg or arm bone or perpendicular to thesubject's leg or arm bone. In varying embodiments, long axis and shortaxis scans of the same target muscle may also be compared.

FIG. 14 conceptually illustrates charts from several additionalapplications of SNDGS 100 and or method 300/350/400/1900/1950. In FIG.1400A, the first, second and third fuel scans as evaluated show verylittle difference for the target muscle, indicating that the subject isnot in a prime condition for continued training (e.g., the muscles arefatigued), and though he or she may feel fine, heavy exertion may indeedovertax the muscles, and a lesser workout or even rest may be preferableto continuing the current exercise routine.

In FIG. 1400B, a scan 1402 of a target muscle in a subject's left leg,e.g. left vastus lateralis, are plotted with the scan 1404 of a targetmuscle in the subject's right leg, e.g., right vastus lateralis which isshown to be similar but faster in depletion as the subject is undergoingrehabilitation.

In FIG. 14C different target muscles are plotted together, such as therectus femoris 1406 and vastus lateralis 1408 of a subject forcomparison and review of how different muscles are or are not similarlydepleting their respective fuel during active use.

With respect to the above description of SNGDS 100 and methods 300, 350,400, 1900 and 1950 it is understood and appreciated that the method maybe rendered in a variety of different forms of code and instruction asmay be preferred for different computer systems and environments. Toexpand upon the initial suggestion of a processor based device such as acomputer 108 shown in FIG. 1 and discussed above, FIG. 15 is ahigh-level block diagram of an exemplary computer system 1500. Computersystem 1500 has a case 1502, enclosing a main board 1504. The main boardhas a system bus 1506, connection ports 1508, a processing unit, such asCentral Processing Unit (CPU) 1510 and a memory storage device, such asmain memory 1512, and optionally a solid state drive or hard drive 1514and/or CD/DVD ROM drive 1516.

Memory bus 1518 couples main memory 1512 to CPU 1510. A system bus 1506couples hard drive 1514, CD/DVD ROM drive 1516 and connection ports 1508to CPU 1510. Multiple input devices may be provided, such as for examplea mouse 1520 and keyboard 1522. Multiple output devices may also beprovided, such as for example a video display 1524 and a printer (notshown). In varying embodiments, the video display may also be a touchsensitive input device.

Computer system 1500 may be a commercially available system, such as adesktop workstation unit provided by IBM, Dell Computers, Gateway,Apple, Sun Micro Systems, or other computer system provider. Computersystem 1500 may also be a smart phone or tablet computer such as aniPhone or iPad provided by Apple, the HP Slate, the Augen or ArchosAndroid tablets, the Motorola Xoom or other such device. Computer system1500 may also be a networked computer system, wherein memory storagecomponents such as hard drive 1514, additional CPUs 1510 and outputdevices such as printers are provided by physically separate computersystems commonly connected together in the network. Those skilled in theart will understand and appreciate that physical composition ofcomponents and component interconnections comprising computer system1500, and select a computer system 1200 suitable for the schedules to beestablished and maintained.

When computer system 1500 is activated, preferably an operating system1526 will load into main memory 1512 as part of the boot strap startupsequence and ready the computer system 1500 for operation. At thesimplest level, and in the most general sense, the tasks of an operatingsystem fall into specific categories—process management, devicemanagement (including application and user interface management) andmemory management.

In such a computer system 1500, the CPU 1510 is operable to perform oneor more of the methods of non-invasive determination of fuel asdescribed above. Those skilled in the art will understand that acomputer-readable medium 1528 on which is a computer program 1530 fornon-invasive determination of fuel may be provided to the computersystem 1500. The form of the medium 1528 and language of the program1530 are understood to be appropriate for computer system 1500.Utilizing the memory stores, such as for example one or more hard drives1514 and main system memory 1512, the operable CPU 1502 will read theinstructions provided by the computer program 1530 and operate toperform as SNDGS 100 as described above.

With respect to the various forms of the processor based device, such asthe computer 108, further discussed and described as computer 1500,FIGS. 16-18 present alternative embodiments for the structuralarrangement of components comprising SNDGS 100. More specifically, foralternative SNDGS 1600 as shown in FIG. 16 , the ultrasound transducer126 is coupled directly to the computer 108, such that SNDGS 1600 isitself disposed adjacent to the target muscle 106 (not shown).

For alternative SNDGS 1700 shown as FIG. 17 , a dedicated processorbased device such as a customized computer 1702 is provided, as opposedto adapting a pre-existing smart phone, tablet computer or othercomputer system. For SNDGS 1700, the display 116 of SNDGS 1600 is notshown so as to illustrate that alternative output devices such as anindicator 1704, lights 1706, speaker 1708, vibrator 1710 and/orcombinations thereof can provide an operator with an indication of thenon-invasively determined fuel. As with SNDGS 1600, the ultrasoundtransducer 126 may be directly coupled to the customized computer 1702,or tethered by a communications link 1712—wireless or wired as shown.

Further, for yet other embodiments, the computer program 112 to adapt acomputer 108 may be provided directly by enhanced ultrasound transducer1800. More specifically, computer program 112 may be incorporated aspart of the circuit structure 1802 of enhanced ultrasound transducer1800 such that upon connection to computer 108, SNDGS 100 is provided.

As suggested above with respect to FIG. 1 , the computer program 112 mayalso be provided by a non-portable media such as a disc 114 to a thirdparty computer, such as computer 1804, providing an application platformsuch as but not limited to the Apple App Store. A user can then connecthis or her computer 108, such as tablet computer 1806 to the third partycomputer 1804 by a network 1808 (wired or wireless) or othercommunication channel and obtain computer program 112 so as to adapt hisor her computer 1806 to perform as SNDGS 100 when a scan of a targetmuscle is provided. In varying embodiments, this scan may be provided bycoupling computer 1806 to ultrasound transducer 126 operated asdescribed above, receiving a scan of a target muscle from internalstorage 1810, or receiving a scan of a target muscle another computersystem 1812 via wired or wireless network 1814, or other appropriatecommunication channel.

Moreover, embodiments of SNDGS 100/1600/1700 are intended for a widerange of subjects. In many instances the primary user of SNDGS100/1600/1700 is a coach or trainer who utilizes SNDGS 100/1600/1700 asan advantageous tool, as he or she can scan target muscles in athletesduring training and test in real time at and during competition,regulations permitting, to better ensure optimum performance. Likewisewith respect to civilian or military medical care, a doctor, nurse,therapist, or caregiver may utilize SNDGS 100/1600/1700 to ensure thatpatents under his or her care are receiving a proper balance ofcarbohydrates, water and muscle stimulating exercise. Further, amilitary commander and/or training officer can utilize SNDGS100/1600/1700 to forecast requirements so that operating members of ateam during a mission have sufficient food resources. And of course useof embodiments of SNDGS 100/1600/1700 are not strictly limited to humanbeings. Indeed, horse trainers, zoo veterinarians and other parties mayemploy the use of embodiments of SNDGS 100/1600/1700 to non-invasivelydetermine the muscle fuel of the animals entrusted to their care.

In further embodiments, determination of a subject's muscle fuel valuecan be used to provide an estimated fuel level for a muscle, i.e., therelative level of fuel a muscle has at any given time, as compared toits historical fuel levels. Estimated fuel level for a muscle takesadvantage of previously determined fuel value data sets for a targetmuscle. Over the course of days, months, or years an indicator muscle ortarget muscle can be tested for fuel values and a data set established(discussed above). Once a fuel value data set has been established forthe target muscle, an estimated fuel level can be determined for themuscle at that time. A newly tested, real time, or current fuel value iscompleted and compared to the muscle's fuel value data set and given apercent against the 100% or “full” fuel value (highest recorded fuelvalue from indicator muscle or target muscle data set) to 1% or “empty”fuel value (lowest recorded fuel value from the indicator muscle ortarget muscle data set). So for example, a muscle that shows a raw scorethat is 60% of the maximum or full fuel value, will have an estimatedfuel level of 60% as to that visit. This score is unique to that subjectand to that subject's tested or indicator muscle. The estimated fuellevel is an indicator of the muscle's readiness, i.e., essentially, “isthat muscle's fuel tank full?” The estimated fuel value also tracks amuscle's depletion and recovery, so for example, as described above, asecond fuel value testing can be performed on the target muscle after anexercise regime to see the effects on the muscle's estimated fuel level.The depletion of the muscle's fuel level can then be used to accuratelypredict how the subject's muscle(s) will react to performanceparameters, such that, for example, an athlete can track fuelconsumption for an athletic event or military personnel can track fuelconsumption for a mission.

In some embodiments, particularly where there has been a smaller numberof fuel value determinations completed for a muscle, the maximum fuelvalue or “full tank” value is given a 75% or 80%, not 100%, of apotential fuel value reading. In this way, it allows for the recognitionthat additional fuel value readings could exceed the maximum testedvalue, for example be 87%. With additional readings, greater than 20, or30, or 40 for example, the maximum can be reset at 100% of the muscle'sfuel.

FIG. 22 shows one illustrative estimated fuel level schematic where thecurrent value is like a gas gage for a fuel tank 2200. The currentestimated fuel level for a muscle is shown as 66%, meaning the testedmuscle has 66% of the fuel of a fully fueled (historic maximum fuelvalue) target muscle 2202. This estimated fuel level can be used bysubjects, athletic trainers, military personnel and the like to have anaccurate appreciation of their target or indicator muscle, and thereforetheir overall skeletal muscle systems readiness for performance. Anestimated fuel level that is at 5%, 10%, or 15% would indicate that thesubject should rest and re-fuel their muscles prior to any furtherperformance based activities, where an estimated fuel level of above 50%and more typically above 75% would indicate that the subject is preparedfor physical performance.

Once a muscle's estimated full level is determined, a target muscle'sfuel rating may be determined. A muscle's fuel rating utilizes the samefuel values as used to identify the estimated fuel level, but comparesthe number to the historical fuel number for the same muscle over a pastpredetermined number of days, e.g., 30 days, 14 days, 7 days, etc., aperiod of injury, a particular age, etc., or against the same muscle inother individuals of like gender, age, athletic endeavor, profession orother linking parameter. The fuel rating can be a percent based value orcan be a category based value, for example, a subject takes a real timefuel value and fuel level for a target muscle and then compares thatvalue to a group of the same gender and age.

As shown in FIG. 23 , a data bell curve plot is used to show the fuelvalues created from the historical values of a number of otherindividuals, and the current findings plotted 2300. The bell curve plotillustrates the muscle fuel values for the data set. In this embodiment,the fuel value or number 2302 is used to show how the muscle iscurrently scoring categorically (not as a percent) against the otherindividuals, i.e., fuel rating. So for example, is the muscle scoring ina very low, low, average, high, or very high range 2304 rating. Therating tracks long term changes, and tracks effects of changes inbehavior, events (injury, overtraining, weight loss or gain, . . . ) andpotential.

The fuel rating can also be determined by comparing the muscle's fuelvalue to other like target muscles in like individuals, for example,rate the subject's raw score against an individual having the samegender and age, or against an individual involved in the same athleticendeavor, e.g., rate the fuel level of the muscle for a bicep of a 18year old pitcher against the bicep of another 18 year old pitcher, onthe same or competing team. Perhaps, the 18 year old has a bicep with abicep fuel rating that is average against its own historical numbers,but low against other like pitchers of similar age and gender. This dataallows for comparisons and allows for the question, how do my musclescompare to myself historically, or alternatively, how do my musclescompare to others who have been assessed in the same way? As notedabove, the rating can be based on a category (very low, low, average,etc.) or can be a percentile, your target muscle fuel rating is 60% thatof other 30 year old female cyclists in the data set.

The data set for fuel values for a muscle can be increased or decreased.As such, the range for use in determining a target muscle's fuel statuscan be dynamic, as more data points (fuel values) provides for moreaccurate determinations. It is also envisioned that ranges can beestablished for particular uses, for example, a data set range used fora subject during exercise only, at a particular age, or during a periodof target muscle injury, and the like. In some embodiments, two or moredata points can be used to establish the range of fuel values, three ormore, four or more, five or more, six or more, seven or more, and thelike. In some embodiments, a statistical confidence number can be shownas part of the estimated fuel level, so for example, where enough datapoints exist, the fuel level could be reported as 71% with 95%confidence.

In at least one other embodiment, the systems and methods describedherein can be used to rate an energy status of one or more muscles in asubject. As used herein, “muscle energy status” or “energy status” is ascoring value that indicates the performance readiness of a targetedmuscle or of a subject's entire muscle system. In order to determine amuscle's performance readiness, the measured fuel value for the muscleis determined and quantified versus that same muscle's overall capacity(fuel tank), and is then compared to other individual's fuel levels forthe same muscle, i.e., the muscle's fuel rating. The scoring of the fuellevel and fuel rating are combined to give an overall muscle energystatus. The muscle energy status is a composite of these twomeasurements, represented as: muscle energy status=(fuel level+fuelrating)/2. The resulting number provides an excellent compositedetermination as to the muscle's overall capacity to perform. A numberof different score scales can be used to signify the muscle's energystatus. In one aspect, a composite score of 0-33 indicates that themuscle energy status is low or red, 34-66 indicates that the muscleenergy status is average or teal, and a muscle energy score of 67-100indicates that the muscle energy status is high or green. Alternatively,rate of occurrence for a muscle's energy status can be used, where amuscle's energy status over time is plotted and real time numberscompared to those values. Here, the subject's historic muscle energystatus provides the result of the composite score. Based on theinventor's findings, this scale has provided a 0-44 energy score asbeing in the bottom third of most subject's muscle energy status, sothis would be the low or red status, 45-62 energy score is in the middlethird of most subject's energy status, so this would be the average orteal score, and 63-100 is the top third of most subject's muscle energystatus, so this would be the high or green status.

FIG. 24 is a flow diagram in accordance with an embodiment fordetermining a target muscle's energy status 2200. A muscle's energystatus is a composite value made up of the estimated fuel level andmuscle fuel rating. A fully fueled and well rated muscle is at a highmuscle energy status, and can be used for monitoring optimal levels ofreadiness for, as well as recover from, exercise. The method in FIG. 24begins by scanning a target muscle as described herein to receive anultrasound scan 2402. As in previous methods, the scan is evaluated todetermine a fuel value 2404. The fuel value is recorded as an element ofa data set for the target muscle. A range of fuel values is obtained forthe muscle over a course of time and/or visits. Once a sufficient numberof fuel values has been obtained, a range of values is established 2206.In typical embodiments, the range corresponds to the minimum fuel valueand the maximum fuel value, and all values in between, e.g., the minimumfuel value can be scored as a 0 or 1 and the maximum fuel value isscored as a 100 (or 80 as described above). As can be envisioned bythose of skill in the art, other scoring scales can be used, and a 1 to100 is for illustrative purposes only. The fuel level is then comparedto a fuel rating of use for the particular subject, for example, thesame muscle for the same gender and age, to give a muscle fuel rating.

Again referring to FIG. 24 , once an estimated fuel level and fuelrating have been determined, the target muscle's energy status isdetermined 2412. The composite value, for example, 60% estimated fuellevel and 50% fuel rating, result in the energy status for the muscle.The combined results can be used to provide a numerical value (55, forexample), or a status value (55 results in a yellow reading, forexample). A muscle's energy status is an indicator of a muscle'sperformance readiness, particularly, a muscle's full performancereadiness. A muscle that is high in estimated fuel (60% or above) andfuel rated at “above average”, is a muscle that can be trusted to engagein activity and exercise with high likelihood of positive results andlow likelihood of use injuries. Conversely, an estimated fuel of below50% and rated at below 33% (“low” or “very low”), can be expected toperform sub-optimally, for example. The numeric score can be based on amatrix or other useful combination score, and the range itself caninclude any number of values, e.g., 1-4, 1-5, 1-10, 1-50, 1-100 forexample.

As can be imagined, testing of athletes just prior to an event or gameprovides a strong advantage as players can be replaced with otherathletes having optimal performance readiness. For example, a runningback for the local football team may have muscle energy status for hislower body muscles that all rate at in the 3-5 range out of 10, whereashis replacement may show the same muscle groups as being in the 7-9range out of 10. The coach may insert the replacement running back,given his higher muscle performance readiness.

FIG. 25 shows an illustrative muscle energy status chart tracking asubjects numeric score over the course of 7 months 2500. The historicdata can be combined or compared to changes in exercise routines,weight, age, and the like. A subject may have various muscle energystatus charts, one prepared before exercise and one prepared afterexercise, for example.

FIG. 26 is a flow diagram in accordance with another embodiment fordetermining a muscle's energy status 2600. The method includes steps2202, 2204, 2206, 2208 and 2210, in combination with an evaluation ofthe target muscle's fuel symmetry 2602. In this method, the targetmuscle fuel value is also compared to the fuel value for the targetmuscle's symmetrical partner in the subject, i.e., between contralateralmuscles. So for example, the fuel value of a subject's right bicep iscompared to the fuel value of the subject's left bicep. A comparisonbetween the two symmetrical muscles is obtained and the differencedetermined. The fuel symmetry is a +/−value, based on the differencebetween the two symmetrical muscles. FIG. 27 provides an illustrativeschematic of a target muscle, left and right side 2700. In this example,the fuel symmetry of +/−14, meaning that the right muscle has a 14%higher fuel level than the left target muscle 2702. The comparison canbe performed using the raw fuel value for the current scan, or, moretypically, performed using the estimated fuel level (as discussedabove). In typical embodiments, the estimated fuel level is compared. Abalanced fuel symmetry for a target muscle is a good indicator that themuscle is operating with low injury risk and no performance deficits(the read-out in this case would be 0). A high imbalance, possibly dueto an injury in the target muscle, provides an additional scoring aspectto the target muscle's energy status. The fuel symmetry for a subjectcan also be determined for a group of muscles, for example, compare thefuel symmetry for all muscles in a subject's right arm versus for thesubject's left arm. These comparisons can also be used to track trends,particularly where injury and injury recovery are involved.

The combination of the three target muscle testing elements: estimatedfuel level, fuel rating, and optionally, fuel symmetry, provide themuscle energy status for any given target muscle or group of muscles ina subject 2604. The overall energy status therefore takes into accountthe present fuel value for the muscle, how that muscle rates againstitself or other like situated muscles, and how that muscle rates againstits' symmetrical partner.

FIG. 28A-28D show four illustrative muscle energy status reports for atarget muscle. Each illustration comes with different levels ofinformation and feedback for the subject.

As shown in FIG. 29 , in some embodiments, the methods as describedherein may be embodied as a wearable device, such as a smart watch orother device operable to couple around a user's body part. The devicesmay include a transducer 2916 positioned adjacent the user in order toobtain scans and/or other data at a variety of different times, such asduring a user's workout. The devices 2900 may also include a display2922 for providing real time and/or other analysis information to theuser.

As shown in FIG. 30 , in other embodiments, a wearable device 3000 maybe used with a separately wearable transducer 3016. In this way, thedevice 3000 may be coupled around one body part while the transducer3016 obtains one or more scans related to tissues located in anotherbody part. The device 3000 may receive data regarding such scans fromthe transducer 3016, such as wirelessly 3012, and provide real timeand/or other analysis information to the user via a display 3022, forexample a target muscle's current energy status.

As shown in FIG. 31 , in still other embodiments, a wearable device 3100may be used with a transducer implant 3116 located inside the user'sbody. In this way, the device 3100 may obtain one or more scans relatedto tissues located in the body without requiring attachment andpositioning of a transducer for use. The device 3100 may receive dataregarding such scans from the transducer implant 3116, such aswirelessly 3112, and provide real time and/or other analysis informationto the user via a display 3122.

Changes may be made in the above methods, systems and structures withoutdeparting from the scope hereof. It should thus be noted that the mattercontained in the above description and/or shown in the accompanyingdrawings should be interpreted as illustrative and not in a limitingsense. The following claims are intended to cover all generic andspecific features described herein, as well as all statements of thescope of the present method, system and structure, which, as a matter oflanguage, might be said to fall there between.

What is claimed is:
 1. A method, comprising: developing a fuel profilefor a target muscle by: obtaining a first ultrasound scan of the targetmuscle prior to at least one of nutrition or exercise; evaluating thefirst ultrasound scan to determine a first fuel value; obtaining asecond ultrasound scan of the target muscle after the at least one ofnutrition or exercise; and evaluating the second ultrasound scan todetermine a second fuel value; obtaining a current ultrasound scan ofthe target muscle; establishing a current fuel value for the targetmuscle; and ranking the current fuel value within the fuel profile todetermine a current fuel level for the target muscle.
 2. The method ofclaim 1, wherein developing the fuel profile for the target musclefurther comprises evaluating the first fuel value and the second fuelvalue to develop a fuel value range.
 3. The method of claim 2, whereinranking the current fuel value within the fuel profile comprises rankingthe current fuel value within the fuel value range.
 4. The method ofclaim 2, wherein developing the fuel profile for the target musclefurther comprises adjusting the fuel value range to have a range of froma first value to a second value, such that a fuel value: of the firstvalue is a minimum fuel value for the target muscle; and of the secondvalue is a maximum fuel value for the target muscle.
 5. The method ofclaim 1, wherein developing the fuel profile for the target musclefurther comprises determining to obtain at least one additionalultrasound scan.
 6. The method of claim 5, wherein developing the fuelprofile for the target muscle further comprises evaluating the at leastone additional ultrasound scan to determine at least one additional fuelvalue.
 7. The method of claim 1, wherein the at least one of nutritionor exercise comprises both nutrition and exercise.
 8. A method,comprising: developing a fuel profile for a target muscle by: obtaininga series of ultrasound scans of the target muscle at a number of timescorresponding at least to a prior to at least one of nutrition orexercise and an after the at least one of nutrition or exercise; andevaluating the series of ultrasound scans to determine a range of fuelvalues; obtaining a current ultrasound scan of the target muscle;establishing a current fuel value for the target muscle; and ranking thecurrent fuel value within the fuel profile to determine a current fuellevel for the target muscle.
 9. The method of claim 8, whereindeveloping the fuel profile further comprises establishing a lower fenceand an upper fence.
 10. The method of claim 9, wherein developing thefuel profile further comprises discounting values that are at least oneof: lower than the lower fence; or higher than the upper fence.
 11. Themethod of claim 9, wherein developing the fuel profile further comprisesestablishing the range of fuel values between the lower fence and theupper fence.
 12. The method of claim 8, wherein developing the fuelprofile further comprises dividing the range of fuel values based on atleast one median value.
 13. The method of claim 12, wherein developingthe fuel profile further comprises dividing a first portion of the rangeof fuel values based on an additional median value.
 14. The method ofclaim 8, wherein the at least one of nutrition or exercise comprisesnutrition and developing the fuel profile further comprises: obtaining athird ultrasound scan of the target muscle prior to exercise; evaluatingthe third ultrasound scan to determine a first fuel value; obtaining afourth ultrasound scan of the target muscle after the exercise; andevaluating the fourth ultrasound scan to determine a second fuel value.15. A method, comprising: developing a fuel profile for a target muscleby: obtaining a series of ultrasound scans of a target muscle at anumber of times corresponding at least to a prior to at least one ofnutrition or exercise and an after the at least one of nutrition orexercise; and evaluating the series of ultrasound scans to determine arange of fuel values; and determining a current fuel level for thetarget muscle using a current ultrasound scan of the target muscle andthe fuel profile.
 16. The method of claim 15, wherein developing thefuel profile for the target muscle further comprises determining toobtain at least one additional ultrasound scan when the range of fuelvalues is at least partially outside a predetermined range.
 17. Themethod of claim 16, wherein developing the fuel profile for the targetmuscle further comprises evaluating the at least one additionalultrasound scan to determine at least one additional fuel value.
 18. Themethod of claim 15, wherein a processing unit tracks the current fuellevel for the target muscle over time.
 19. The method of claim 15,wherein developing the fuel profile for the target muscle furthercomprises determining to obtain at least one additional ultrasound scanwhen the series of ultrasound scans includes less than a thresholdnumber of ultrasound scans.
 20. The method of claim 15, wherein theseries of ultrasound scans are of a different muscle than the targetmuscle.